Most sexually active people will contract human papillomavirus (HPV) at some point in their lifetime. HPV is the most common sexually transmitted infection (STI) in the United States. More than 100 types of HPV exist, and more than 40 subtypes of HPV can affect the genital area and throat.
HPV spreads by skin-to-skin contact. Most people contract HPV in their genital area through sexual intercourse. If you engage in oral sex, you may contract it in your mouth or throat. This is most commonly known as oral HPV.
Oral HPV often has no symptoms. This means that people don’t realize they’re infected and are less likely to take the steps necessary to limit the spread of the disease. It’s possible to develop warts in the mouth or throat in certain cases, but this is less common.
This type of HPV can turn into oropharyngeal cancer, which is rare. If you have oropharyngeal cancer, cancer cells form in the middle of the throat, including the tongue, tonsils, and pharynx walls. These cells can develop from oral HPV. Early symptoms of oropharyngeal cancer include:
- trouble swallowing
- constant earaches
- coughing up blood
- unexplained weight loss
- enlarged lymph nodes
- constant sore throats
- lumps on the cheeks
- growths or lumps on the neck
If you notice any of these symptoms and you know or think you may have HPV, make an appointment with your doctor immediately.
Oral HPV occurs when a virus enters the body, usually through a cut or small tear inside of the mouth. People often get it through having oral sex. More research is necessary to determine exactly how people get and pass on oral HPV infections.
Approximately 7 percent of Americans ages 14 to 69 have oral HPV. The number of people who have oral HPV has increased over the past three decades. It’s more common in men than in women.
Approximately two-thirds of oropharyngeal cancers have HPV DNA in them. The most frequent subtype of oral HPV is HPV-16. HPV-16 is considered a high-risk type.
Oropharyngeal cancer is rare. Approximately 1 percent of people have HPV-16. Less than 15,000 people get HPV-positive oropharyngeal cancers each year.
Risk factors for oral HPV include the following:
- Oral sex. Evidence suggests that an increase in oral sexual activity may be a risk, with men being more at risk, especially if they smoke.
- Multiple partners. Having multiple sexual partners may increase your risk. According to the Cleveland Clinic, having more than 20 sexual partners over your lifetime can increase your chances of getting an oral HPV infection by up to 20 percent.
- Smoking. Smoking has been shown to help promote HPV invasion. Inhaling hot smoke makes you more vulnerable to tears and cuts in the mouth, and is also a risk factor for developing oral cancers.
- Drinking alcohol. Research has indicated that a high intake of alcohol increases the risk for HPV infections in men. If you smoke and drink, you’re at an even higher risk.
- Open mouth kissing. Some research has said that open mouth kissing is a risk factor, as it can be transmitted from mouth to mouth, but more research is necessary to determine if this increases your risk for oral HPV.
- Being male. Men have a greater risk of receiving an oral HPV diagnosis than women.
Age is a risk factor for oropharyngeal cancer. It’s more common in older adults because it takes years to develop.
No test is available to determine if you have HPV of the mouth. Your dentist or doctor may discover lesions through a cancer screening, or you may notice the lesions first and make an appointment.
If you have lesions, your doctor can perform a biopsy to see if the lesions are cancerous. They’ll probably also test the biopsy samples for HPV. If HPV is present, the cancer may be more responsive to treatment.
Most types of oral HPV go away before they cause any health issues. If you develop oral warts due to HPV, your doctor will likely remove the warts.
Treating the warts with topical treatments can be difficult because the warts may be hard to reach. Your doctor may use any of the following methods to treat the warts:
- surgical removal
- cryotherapy, which is where the wart is frozen
- interferon alfa-2B (Intron A, Roferon-A), which is an injection
If you do develop oropharyngeal cancer, treatment options are available. Your treatment and prognosis depend on the stage and location of your cancer and whether or not it’s associated with HPV.
HPV-positive oropharyngeal cancers have better outcomes and fewer relapses after treatment than HPV-negative cancers. Treatment for oropharyngeal cancer can include radiation therapy, surgery, chemotherapy, or a combination of these.
Most medical and dental organizations don’t recommend screening for oral HPV. Lifestyle changes are some of the easiest ways to help prevent HPV. Here are some tips for prevention:
- Prevent STIs by practicing safe sex, like using condoms every time you have sex.
- Limit your number of sexual partners.
- Talk to your sexual partners about sex, asking them about the most recent time they’ve been tested for STIs.
- If you’re sexually active, you should be tested regularly for STIs.
- If you’re with an unfamiliar partner, avoid oral sex.
- When having oral sex, use dental dams or condoms to prevent any oral STIs.
- During your six-month checkups at the dentist, ask them to search your mouth for anything abnormal, especially if you have oral sex often.
- Make it a habit to search your mouth for any abnormalities once per month.
- Get vaccinated against HPV.
Vaccination against HPV involves getting two shots spaced six to 12 months apart if you’re between the ages of nine and 14. People aged 15 and over get three shots over six months. You’ll need to get all of your shots for the vaccine to be effective.
The HPV vaccine is a safe and effective vaccine that can protect you from HPV-related diseases.
This vaccine was previously only available to people up until age 26. New guidelines now state people between the ages of 27 and 45 who have not been previously vaccinated for HPV are now eligible for the vaccine Gardasil 9.
In a 2017 study, oral HPV infections were said to be 88 percent lower among young adults who received at least one dose of the HPV vaccine. These vaccines help prevent oropharyngeal cancers linked to HPV.